NPIMap

Organization Active NPI

The University of Tennessee at Chattanooga

Doing business as UTC Student Health Services

  • Student in an Organized Health Care Education/Training Program
  • Chattanooga, TN
National Provider Identifier
1619323599
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
523RPWMF1 Issued in TN
Legal business name
THE UNIVERSITY OF TENNESSEE AT CHATTANOOGA
Doing business as
UTC Student Health Services
Practice address
615 McCallie Ave
Dept. 6856
Chattanooga, TN 37403-2504
Phone
(423) 425-2266
Fax
(423) 425-2305
NPI assigned
May 10, 2016
Last updated
May 10, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
THE UNIVERSITY OF TENNESSEEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Blake Alan Reagan, J.D.
Title
Director of Procurment Services
Phone
(865) 974-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 523RPWMF1 TN Primary

Addresses

Primary practice location

615 McCallie Ave
Dept. 6856
Chattanooga, TN 37403-2504

Mailing address

615 McCallie Ave
Department 6856
Chattanooga, TN 37403-2504
Phone (423) 425-4111

Other identifiers 1

IdentifierTypeStateIssuer
2016-303-1OtherTNUNITED HEALTHCARE STUDENT RESOURCE PLAN (UHCSR)

Other names 1

  • UTC Student Health Services Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1098912Student Health Services615 McCallie Avenue, Department 6856, Chattanooga, TN 37403Provider-performed microscopyApr 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Univ of Tenn Hospital26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

615 McCallie Ave
#6856
Chattanooga, TN 37403
Phone (423) 425-2266

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1619323599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MCCALLIE AVE",
            "address_2": "DEPARTMENT 6856",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032504",
            "telephone_number": "423-425-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MCCALLIE AVE",
            "address_2": "DEPT. 6856",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032504",
            "telephone_number": "423-425-2266",
            "fax_number": "423-425-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UNIVERSITY OF TENNESSEE AT CHATTANOOGA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE UNIVERSITY OF TENNESSEE",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "REAGAN",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "DIRECTOR OF PROCURMENT SERVICES",
        "authorized_official_telephone_number": "865-974-3311",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": "523RPWMF1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE STUDENT RESOURCE PLAN (UHCSR)",
            "identifier": "2016-303-1",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTC Student Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.